Heart aging measured with coronary artery calcium scoring and cardiovascular risk assessment algorithms in HIV infected patients

Raggi, Paolo; Corwin, Catherine

doi:10.1080/21505594.2016.1212154

Cited by 4 publications

(4 citation statements)

References 36 publications

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“…A higher incidence of atherosclerosis among HIV-infected patients has been demonstrated in previous studies [ 14 - 16 ], and subclinical atherosclerosis can be assessed using the CAC score [ 17 - 19 ]. In the present study, we evaluated the usefulness of MDCT in quantifying the progression of coronary calcium levels and assessing the evolution of cardiovascular risk in a cohort of patients with long-term HIV.…”

Section: Discussionmentioning

confidence: 98%

Progression of subclinical cardiovascular disease in patients with HIV

Fayos,

Arnaiz de las Revillas,

González Quintanilla

et al. 2024

Rev Esp Quimioter

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Introduction. Human immunodeficiency virus (HIV) infected patients are at increased risk of cardiovascular disease (CVD). Multidetector computed tomography (MDCT) stratifies cardiovascular risk in asymptomatic patients with subclinical atherosclerosis. The aim of this study was to determine the ability of MCTD and clinical and laboratory parameters to assess subclinical CVD progression in HIV patients. Material and methods. Prospective longitudinal cohort study of patients with at least 10 years of HIV infection and 5 years of antiretroviral therapy history, low cardiovascular risk and monitored for 6 years (2015–2021). All patients underwent clinical assessment, blood analysis, carotid ultrasound, and gated MDCT in 2015 and 2021. Results. Sixty-three patients (63.5% male) with a mean age of 49.9 years (standard deviation [SD], 10.5) were included in 2015; 63 of them were followed until 2021. Comparing the results from 2015 with those from 2021, Systematic Coronary Risk Estimation-2 (SCORE2) was 2.9% (SD, 2.1) vs. 4.4% (SD,3.1); Multi-Ethnic Study of Atherosclerosis score (MESA risk) was 3.4 (SD 5.8) vs. 6.0 (SD 8.6); coronary artery calcification CAC) score >100 was 11.1% vs. 25.4% (P < 0.05); and 11% vs. 27% had carotid plaques (P = 0.03). Conclusions. After six years of follow-up, an increase in SCORE2, carotid plaques, CAC scoring and MESA risk was observed. MDCT findings, along with other clinical and laboratory parameters, could play an important role as a marker of CVD progression in the evaluation of patients with HIV and low cardiovascular risk.

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Section: Discussionmentioning

confidence: 98%

Progression of subclinical cardiovascular disease in patients with HIV

Fayos,

Arnaiz de las Revillas,

González Quintanilla

et al. 2024

Rev Esp Quimioter

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“… 57 Our findings are consistent with prior literature, including an earlier, more limited review published in 2015, which found that participants with HIV have a higher prevalence of noncalcified plaques, which may be more prone to erosion and rupture. 4 , 5 , 6 , 10 , 29 , 32 , 33 In prior studies assessing actual cardiovascular events in patients with HIV compared with patients without HIV, there seems to be a consensus that patients with HIV are at increased risk of coronary events, in the range of 1.25‐ to 1.75‐fold higher risk. 65 , 66 , 67 , 68 , 69 , 70 The higher prevalence of noncalcified plaque and possibly earlier onset of CAC (as suggested by prior studies and this meta‐analysis), may explain the higher risk of CVD observed in patients with HIV.…”

Section: Discussionmentioning

confidence: 99%

“…3 , 4 Because traditional risk factor calculators may not adequately capture the full extent of the CVD risk in this population, CT imaging markers such as coronary artery calcium (CAC) may be useful to fill in this gap for risk assessment. 5 Prior studies have suggested that patients with HIV have a higher burden of subclinical atherosclerosis, including carotid stenosis and accelerated coronary aging based on CAC score measures. 6 , 7 , 8 Additionally, asymptomatic patients with HIV have been reported to have higher rates of noncalcified plaques in some studies, 6 which are considered higher risk for rupture leading to cardiac events.…”

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confidence: 99%

Coronary Artery Calcification and Plaque Characteristics in People Living With HIV: A Systematic Review and Meta‐Analysis

Soares

Samara

Yuyun

et al. 2021

JAHA

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Background Studies have reported that people living with HIV have higher burden of subclinical cardiovascular disease, but the data are not adequately synthesized. We performed meta‐analyses of studies of coronary artery calcium and coronary plaque in people living with HIV. Methods and Results We performed systematic search in electronic databases, and data were abstracted in standardized forms. Study‐specific estimates were pooled using meta‐analysis. 43 reports representing 27 unique studies and involving 10 867 participants (6699 HIV positive, 4168 HIV negative, mean age 52 years, 86% men, 32% Black) were included. The HIV‐positive participants were younger (mean age 49 versus 57 years) and had lower Framingham Risk Score (mean score 6 versus 18) compared with the HIV‐negative participants. The pooled estimate of percentage with coronary artery calcium >0 was 45% (95% CI, 43%–47%) for HIV‐positive participants, and 52% (50%–53%) for HIV‐negative participants. This difference was no longer significant after adjusting for difference in Framingham Risk Score between the 2 groups. The odds ratio of coronary artery calcium progression for HIV‐positive versus ‐negative participants was 1.64 (95% CI, 0.91–2.37). The pooled estimate for prevalence of noncalcified plaque was 49% (95% CI, 47%–52%) versus 20% (95% CI, 17%–23%) for HIV‐positive versus HIV‐negative participants, respectively. Odds ratio for noncalcified plaque for HIV‐positive versus ‐negative participants was 1.23 (95% CI, 1.08–1.38). There was significant heterogeneity that was only partially explained by available study‐level characteristics. Conclusions People living with HIV have higher prevalence of noncalcified coronary plaques and similar prevalence of coronary artery calcium, compared with HIV‐negative individuals. Future studies on coronary artery calcium and plaque progression can further elucidate subclinical atherosclerosis in people living with HIV.

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“…Vascular age assessment goes beyond any statistical probability of risk and allows to identify patient vulnerability in patients with preclinical cardiovascular disease. 22 Finally, it may be inappropriate to utilize in HIV patients cardiovascular risk prediction algorithms (namely Framingham Risk score and ASCVD) calibrated to predict an "atherosclerotic event" in the general population, to estimate the risk of events which, in more than 50% of the cases, are non-atherosclerotic in HIVC patients, including sepsis, vasospasm due to cocaine use, anemia, acute volume fluctuations etc. 23 Future studies may need to address the calibration of various algorithms to separate the risk of type-1 from type-2 MI.…”

mentioning

confidence: 99%